Lee Jun-Ku, Lee Soo-Hyun, Kim Banghyun, Jung Kyunghun, Park Inkeun, Han Soo-Hong
Inje University Seoul Paik Hospital Department of Orthopaedic Surgery.
Bundang CHA Medical Center Department of Orthopedic surgery.
Handchir Mikrochir Plast Chir. 2018 Sep;50(5):335-340. doi: 10.1055/a-0747-5982. Epub 2018 Nov 7.
Although the major cause of carpal tunnel syndrome (CTS) remains idiopathic, many male CTS patients are clinically different from female patients and often have specific risk factors associated with their conditions. An accurate analysis of such propensity has yet to be established. The purpose of this study is to compare male and female patients by analyzing the risk factors associated with CTS patients who underwent surgical treatment, with focus on their occupation.
PATIENTS/MATERIAL AND METHODS: retrospective chart review of 818 patients with CTS was performed to identify the associated risk factors. Patients were stratified by gender: female (n = 707, 86.4 %) and male (n = 111, 13.6 %). The mean patient age was 54.5 (range: 16-85 yr.) for all groups. The medical history and risk factors of each patient was thoroughly reviewed by medical charts and telephone survey. We categorized the risk factors of CTS into 7 categories: anatomic, neuropathic, inflammatory, alteration of fluid balance, distal radius fracture associated, occupational risk factor related, and idiopathic. Occupations of CTS patients were divided into high risk occupations (vibratory tools, assembly jobs, and food processing and packaging jobs, and other occupations of repetitive wrist motion and forceful gripping) and nonrisk occupations. All variables were analyzed with chi-square or Fisher's exact test for differences between men and women.
The number of individuals with known risk factors of CTS was greater in male, compared to that of female patients; 97 (87.4 %) male patients had the risk factors of CTS, while 361 (51.1 %) female patients (p < 0.001) did. In subgroup analysis of risk factors, male patients had frequent risk factors in neuropathic, inflammatory, and alteration of fluid balance (p < 0.001). Occupational risk was strongly associated with male gender (p < 0.001).
Male CTS patients who underwent surgery are more likely to have a reason and have many occupational risk factors than women.
尽管腕管综合征（CTS）的主要病因仍不明，但许多男性CTS患者在临床上与女性患者不同，且往往有与其病情相关的特定风险因素。尚未建立对这种倾向的准确分析方法。本研究的目的是通过分析接受手术治疗的CTS患者的风险因素，比较男性和女性患者，重点关注其职业。
患者/材料与方法：对818例CTS患者进行回顾性病历审查以确定相关风险因素。患者按性别分层：女性（n = 707，86.4%）和男性（n = 111，13.6%）。所有组患者的平均年龄为54.5岁（范围：16 - 85岁）。通过病历和电话调查对每位患者的病史和风险因素进行了全面审查。我们将CTS的风险因素分为7类：解剖学、神经性、炎症性、液体平衡改变、与桡骨远端骨折相关、职业风险因素相关和特发性。CTS患者的职业分为高风险职业（振动工具、装配工作、食品加工和包装工作以及其他重复性手腕运动和强力抓握的职业）和非风险职业。所有变量采用卡方检验或Fisher精确检验分析男女之间的差异。
已知CTS风险因素的男性个体数量多于女性患者；97例（87.4%）男性患者有CTS风险因素，而361例（51.1%）女性患者有（p < 0.001）。在风险因素亚组分析中，男性患者在神经性、炎症性和液体平衡改变方面有频繁的风险因素（p < 0.001）。职业风险与男性性别密切相关（p < 0.001）。
接受手术的男性CTS患者比女性更可能有病因且有许多职业风险因素。
